Can Juvederm or Restylane Be Injected on the Forehead?

Juvederm or Restylane to fill in forehead lines is off-label like many other uses of these products. I routinely use fillers in forehead lines that do not respond completely to Botox. I have used Juvederm, Restylane, Radiesse, Evolence, Elevess on scores of patients with no complications. I think the risk of skin necrosis (barring intravascular injection) is extremely small if the product is injected intradermally by an injector experienced in this area.

Hi Trish,
The risk of necrosis in this area is higher than other areas of the face. But just like all "off label" uses of injection products, the results and potential for side effects will depend on the skill of your practitioner.
We certainly respect the choices your physician is making in regard to injecting the forehead, but we believe Restylane is a good option for your problem and an option that we have used in many cases like yours. Good luck.

Juvederm or Restylane are facial fillers which can often be used in conjunction with Botox to treat forehead wrinkles. Having said this, Botox for most people works great by itself; and is used for the horizontal forehead wrinkles, the vertical lines between the brows and the crows feet lines around the eyes.
However, sometimes, the vertical lines between the eyes are very deep and entrenched. That is when you know one of the facial fillers may be necessary. While complications can occur, I have treated hundreds of patients in this manner without even a hint of ulcerations.

Dear Trish
You have a very good question and are correct about the 'off label' use of fillers in the forehead but it can be done safely.
The combination of the fillers and Botox can give a very long lasting and pleasing result.
With Warm Regards,
Trevor M Born MD

Hi Trish,
Both Juvederm and Restylane can be used "off-label" to fill the vertical forehead lines between the eyebrows (glabellar lines). In fact, when Botox and either Juvederm or Restylane is used concurrently in this area, there is a synergistic effect that creates a very long lasting (many times permanent) elimination of the lines, even when the Botox wears off.
If your dermatologist is uncomfortable injecting in that area, certainly do not have him/her inject you. You do need to choose a very well trained and experienced injector for this treatment as severe complications have been reported if injected in the incorrect manner.
Good luck and be well.
Dr. P

Your dermatologist is correct that there is a risk of ulceration or necrosis (death) of the skin surface. This can happen in this location if too much filler is used, or if too thick a filler is used. It is done without complication, but, this risk does exist in all cases.
 

Dear Trish
While injection into the glabellar area can cause necrosis. The key is subdermal placement without overfill. By monitoring the capillary filling disturbances in the circulation can be treated with the enzyme hyaluronidase. My best recommendation is don't make your dermatologist do something they are not comfortable with. Consider looking at the liquidfacelift.com website for the name of an experienced injector in your area.

Yes, it can be done.
The risk of necrosis is a real risk. However, it can be minimized if not eliminated by injecting without pressure. It should be done in small amounts. Also, the doctor performing this should be familiar with the signs of vascular compromise that usually happens immediately causing white colored blanching of skin. She/he needs to be trained in how to treat it by aggressive immediate massage, applying Nitroglycerin, squeezing some of the material out by making a small incision and in the worst case using Hyperbaric Oxygen to treat the early necrosis.
Regards

Your dermatologist is correct to be cautious with injecting the forehead with fillers. It would be considered an "off label" use of the filler. However, filler can be very effective for these areas when used correctly and conservatively. Also, give the Botox a chance. When you significant static wrinkles, it often takes several treatments with Botox before you see a change. The dynamic wrinkles, however, you should see a positive change with the first treatment of Botox.

The risk of skin necrosis from forehead or glabella region restylane injection is real but very minimal, if injected correctly (superficial, slow injection), avoiding vessels.  Botox treats dynamic lines, not static lines such as the vertical crease in your forehead.